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Procedure
Percutaneous transluminal angioplasty (PCTA) is a procedure in which a balloon-tipped catheter is threaded into a coronary artery that is narrowed by fatty plaques (atherosclerosis).
Inflation of the balloon reduces or removes the blockage, improving balloon flow and decreasing signs of coronary artery disease such as angina (chest pain). PCTA has become accepted as an alternative to coronary artery bypass surgery, particularly when only one of the four coronary arteries is diseased.
Complications of PCTA include arterial occlusion during the procedure, usually due to movement of the fatty plaque from the arterial wall into the arterial lumen (dissection), recurrence of disease (restonosis) after the procedure, and inability to treat arteries which are completely blocked.
Lasers have now been used during PCTA to resolve some of these problems. Lasers may either be used directly to vaporize the plaque, or as thermal agents for heating another probe which can burn away the plaque. Numerous reports suggest that laser angioplasty may be effective in some patients, although probe heating by the laser may have its own complications.
Refinements in patient selection and excimer laser technique have resulted in improved procedural outcome. The overall rates of clinical success for excimer laser angioplasty are approximately 90 percent, major and minor complications 6 percent, and vessel perforation 1 percent.
Laser angioplasty has not been shown to be uniformly more successful than traditional PCTA, although further research is being done.
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